Laparoscopy

What Is a Laparoscopy?

Laparoscopy is a type of surgery. As a diagnostic procedure, it is used to examine the organs inside your abdomen. This is also referred to as a diagnostic laparoscopy.

Laparoscopy is a minimally invasive procedure. Only small incisions are made.

Laparoscopy uses an instrument called a laparoscope. The laparoscope is a long, thin tube with a high-intensity light and a high-resolution camera at the front. The instrument is inserted through an incision in your abdominal wall. As it moves along, the camera relays images to a video monitor.

Laparoscopy allows your physician to see inside your body in real time, without open surgery. Your physician also can obtain biopsy samples during this procedure.

Diagnostic Uses of Laparoscopy

A laparoscopy often is used to identify and diagnose the source of abdominal or pelvic pain. It usually is performed after other noninvasive options have been tried.

In many cases, abdominal problems are observed with imaging techniques such as:

ultrasound

computed tomography (CT) scan

magnetic resonance imaging (MRI)

When these tests cannot provide enough data for diagnosis, a laparoscopy is used to find more details. The procedure also can be used to take a biopsy.

Your physician may recommend laparoscopy to examine the following organs:

appendix

gallbladder

liver

pancreas

small and large bowel

spleen

stomach

pelvic or reproductive organs

By observing these areas with a laparoscope, your physician can investigate:

abdominal pain

an abdominal mass or tumor

fluid in the abdominal cavity

liver disease

the effectiveness of certain treatments

the degree to which a cancer has progressed

Administration of Laparoscopy

A laparoscopy usually is administered as an outpatient procedure. It may be performed in a hospital or an outpatient surgical center.

After changing into a hospital gown, an IV line will be put in your hand or arm.

You will generally be given general anesthesia for this procedure. This means you will sleep through it and not feel any pain. In some cases, local anesthesia with sedation is used instead. You still will not feel any pain, but you can be woken up if needed.

If you need to be awake, local anesthetic will be used to numb the laparoscopy site. A small incision will be made below your navel. A small tube called a cannula will be inserted. This is used to inflate your abdomen with carbon dioxide gas. Then the laparoscope will be inserted. You may feel pressure but should not feel pain.

Up to a total of four cuts will be made. These allow other instruments to be inserted. For example, your doctor may need to perform a biopsy.

After the procedure is done, the instruments will be removed. Your incisions will be closed with absorbable stitches or surgical tape. Bandages may be placed over the incisions.

Recovery from Laparoscopy

When your laparoscopy is completed, you will be observed for several hours before you are released from the hospital. The timing of your release will vary. It depends on:

your overall physical condition

the type of anesthesia used

your body’s reaction to the procedure.

In some cases, you may have to remain overnight.

Generally, you will be taken to a recovery room. While there, you will be checked for any reaction to the anesthesia or the procedure. Your vital signs will be monitored.

When the effects of your anesthesia wear off, you will be discharged. However, if you received general anesthesia, you will not be permitted to drive yourself home.

After your laparoscopy, you can expect to feel slight pain and throbbing at the surgical sites. Any pain or discomfort should improve daily. Your physician may prescribe medication to relieve the pain.

It is not uncommon to have shoulder pain after your procedure. This occurs when the carbon dioxide gas causes an irritation in your diaphragm, which shares nerves with your shoulder. The carbon dioxide may also cause some bloating.

You will be told not to lift any heavy objects for about a week.

Typically, you can go back to eating your normal diet when you feel hungry.

You usually can resume all normal activities within a week. You will need to return to your physician in about two weeks.

Risks of a Laparoscopy

The most common complications for laparoscopy are bleeding and infection. Complications are rare.

After your procedure, watch for any signs of infection. Contact your physician if you experience:

abdominal pain that grows more intense

chills and/or fever

changes in your incision sites, such as redness, swelling, bleeding, or drainage

continued nausea or vomiting

bleeding

persistent cough or breathlessness

inability to urinate

feeling faint or weak

There is a small risk of damage to the targeted organ or nearby areas during a laparoscopy. If an organ is punctured, leakage of blood or other fluids may occur. In this case, you will need other surgery to repair the damage.

All surgeries also put you at risk of the following rare complications:

reactions to general anesthesia

inflammation of the abdominal wall

a blood clot, which could travel to your pelvis, legs, lungs; In rare cases, the blood clot could enter your heart or brain.

Preparation for a Laparoscopy

Preparations for a laparoscopy are similar to those for any surgery.

You should tell your physician about any prescription or over-the-counter medications you are taking. Discuss how they should be used before and during the test.

Your physician may change the dose of any medications that could affect the outcome of your laparoscopy. These include:

Tell your physician if you are pregnant, or think you might be pregnant. This will reduce the risk of harm to your developing baby.

Prior to your laparoscopy, your physician may require a blood test and urinalysis. An electrocardiogram (EKG or ECG) and chest X-ray also may be needed.

Your physician also may request imaging studies, such as an:

ultrasound

CT scan

MRI

The data from an imaging study can help your surgeon better understand the abnormality being investigated. The results also give your surgeon a visual guide to the inside of your abdomen. This can improve the effectiveness of your laparoscopy.

You will need to fast from food and drink for at least eight hours prior to your laparoscopy. If you are given a sedative to take at home before the procedure, you will not be able to drive yourself to the surgical site.

Results of a Laparoscopy

The surgeon who performed your laparoscopy will analyze the findings. If a biopsy was taken, it will be examined by a pathologist. A pathologist is a physician who specializes in tissue analysis.

A report detailing the results will be sent to your doctor.

Normal results indicate the absence of abdominal bleeding, hernias, and intestinal blockages. They also mean that all your organs are healthy in appearance and size.

Abnormal results from a laparoscopy can indicate any one of numerous conditions, including:

adhesions or surgical scars

appendicitis

benign uterine tumors, or fibroids

cancer

cholecystitis—inflammation of the gall bladder

cysts or tumors

endometriosis—tissue from the inside of the uterus grows outside the uterus

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